Sun Protection Policies and Practices in Preschool and Elementary Schools in Andalusia (Spain)

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Sun Protection Policies and Practices in Preschool and Elementary Schools in Andalusia (Spain) Cristina García-Harana 1,2 & María Victoria de Gálvez Aranda 2 & Nuria Blazquez-Sanchez 1 & Francisco Rivas-Ruiz 3,4 & A. Rodriguez-Martinez 5 & Magdalena de Troya-Martín 1 Accepted: 28 September 2020 # American Association for Cancer Education 2020

Abstract Sun exposure in childhood is a major risk factor for the development of skin cancer as an adult. School children spend much of their time outdoors exposed to ultraviolet radiation during recreational and sports activities. Skin cancer incidence tripled from 1978 to 2002 in Spain. Andalusia, the largest and sunniest region of Spain, lacks data on the sun protection measures taken in schools. To address this deficit, the aim of this study was to determine photoprotection practices and policies in preschools and primary schools in Andalusia. This descriptive study involved the administration of an online questionnaire completed by principals regarding school sun protection policies and practices. Preschool and primary schools were selected from the database of the Ministry of Education of the Andalusian Regional Government. Information of interest included photoprotection policies, students’ sun protection knowledge, sun protection measures, relevant curricular content, and availability of shade at the school. A total of 2425 schools were contacted. Of them, 420 schools responded (17.31%), with the highest number of responses received from Malaga (23.8%) and Seville (19.5%) provinces. Of those responding, 67.1% of the schools did not have written sun protection policies. The photoprotection measures reported included mandatory use of a cap or hat (3.3%), use of sunglasses in outdoor areas (30%), and active encouragement of students to use sunscreen (50.7%). Roughly 24% of schools evaluated their shaded areas, with 52.9% reporting insufficient protection for most activities. The study results showed that photoprotection policies and practices in Andalusian schools were mostly insufficient. Given that skin cancer incidence has increased considerably over the last decade, it is important to concentrate on improving primary prevention practices. Additionally, photoprotection programs in schools have been shown to improve children’s knowledge, attitudes, and habits regarding photoprotection. Thus, it is essential for Andalusian preschools and primary schools to develop policies and strategies to help reduce children’s sun exposure while at school. Keywords Sun protection . Schools . Spain . Policies

Introduction Incidence of skin cancer is increasing faster than any other type of malignant neoplasm worldwide as a consequence of deliberate sun exposure [1]. It is estimated that ultraviolet radiation (UVR) is responsible for more than 65% of melanoma cases and 99% of basal cell and squamous cell carcinoma

cases [2]. In Spain, coinciding with the trend observed internationally, incidence of skin cancer has tripled from 1978 to 2002 [3]. Childhood is a critical stage, as UVR i